title: Bile acids and gut peptide secretion after bariatric surgery: a 1-year prospective randomized pilot trial.
abstract: OBJECTIVE
  Increased delivery of bile acid salts (BA) to distal L-cells and altered TGR5 receptor activation may contribute to the early and substantial increases in gut peptide secretion seen after bariatric surgery. To further elucidate a potential role of BA in the secretion of GLP-1 and PYY, we analyzed plasma BA concentrations in 14 morbidly obese patients undergoing gastric bypass or sleeve gastrectomy in a prospective, randomized 1-year trial.
  
  
  METHODS
  Patients received a standard test meal and blood was collected before and after eating, prior to, and 1 week, 3 months, and 12 months after surgery.
  
  
  RESULTS
  Pre-surgery, basal BA concentrations were significantly lower in bariatric patients than in healthy controls. One year post-surgery, bariatric patients expressed variably increased BA concentrations (gastric bypass patients ∼2 fold increase, P ≤ 0.05). However, whereas in both patient groups, marked increases in GLP-1 and PYY and improved glycemic control was seen already 1 week and 3 months post-surgery, changes in plasma BA followed a different pattern: basal and postprandial plasma BA concentrations increased much slower, more progressively with significant increases only 1-year post-surgery.
  
  
  CONCLUSIONS
  Based on these findings, BA do not appear to be key mediators of the early increase in GLP-1 and PYY response in post-bariatric patients.
authors.affiliation: Department of Biomedicine and Division of Gastroenterology, University Hospital Basel, Switzerland; Discipline of Medicine, University of Adelaide, Level 6 Eleanor Harrald Building, Royal Adelaide Hospital, Frome Road, Adelaide, 5005, South Australia.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Steinert
authors.forename: Ralph
authors.initials: R
authors.lastname: Peterli
authors.forename: Sylvia
authors.initials: S
authors.lastname: Keller
authors.forename: Anne C
authors.initials: AC
authors.lastname: Meyer-Gerspach
authors.forename: Jürgen
authors.initials: J
authors.lastname: Drewe
authors.forename: Thomas
authors.initials: T
authors.lastname: Peters
authors.forename: Christoph
authors.initials: C
authors.lastname: Beglinger
mesh_terms: D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood* / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001835:Body Weight; D005743:Gastrectomy; D015390:Gastric Bypass; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D006801:Humans; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery; D019894:Peptide YY / Q000097:blood; D010865:Pilot Projects; D019518:Postprandial Period; D011446:Prospective Studies
chemical_list: D001647:Bile Acids and Salts; D001786:Blood Glucose; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1